On Technology

Press 1 for… Press 2 for…

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Does hearing this cause anxiety and impatience? Or do you think, great, I’ll soon be talking to the right person to help me? I am usually impatient when it comes to getting help with something. I find it frustrating canstockphoto20456258to listen to a long list of phone options, to wait for someone to be available, then get bounced around between call center staff and repeat my information multiple times.

But call centers and automated attendant systems are our new reality. There will be more use of artificial intelligence (AI) and Chatbots in the future. If designed properly, the customer experience can be a positive one.

I admit that I quickly forget the experiences that are smooth and positive. But I remember the ones that aren’t. I had one of those not so positive experiences this week.

While driving on the freeway last Friday, something flew off a truck and hit my windshield creating a crescent like crack the size of an orange. Not something to ignore and put off.

Making the call to my insurance company and being routed to the auto glass service they partner with involved getting redirected to different numbers, providing the same information multiple times, and still not getting the result I needed. In the end, I got it worked out when I contacted the service provider directly.

This not so positive experience reinforced how important it is for us to design the optimal flow and support structure for our command center (a call center on steroids) during our upcoming Epic go live at the University of Vermont Health Network. Customer service encounters in some form are an everyday experience. They should be easy, quick, and have a positive outcome. Continue reading →

IT takes a village

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GLRA is an acronym recognized by anyone who has been through a large-scale system implementation. Spelled out it is Go Live Readiness Assessment. It is typically done at the 90, 60, and 30-day mark before canstockphoto16594838 (1) hands puzzlea go live. At the University of Vermont Health Network (UVMHN), our 90-day GLRA for Epic Wave 1 was this week.

Dr. John Brumsted, UVMHN CEO, kicked the day off with a powerful message on how important the Epic project is to the network and our patients. He talked about why we are doing this for the region that includes six hospitals, a medical group, many ambulatory locations and home health and hospice in both Vermont and New York. He set realistic expectations saying it wouldn’t be perfect and there would be issues. But he expressed confidence in the project, and everyone involved in making it a success. His presence for a good portion of the morning spoke volumes about his support for this massive initiative and appreciation for all involved. The network CFO and the University of Vermont Medical Center (UVMMC) president, CNO, CMO and VP for Medical Group Operations were also there for a good portion of the morning.

Dr. Adam Buckley, UVMHN CIO, followed Dr. Brumsted by talking about how the journey to a common, fully integrated EHR began back in 2013.  A journey that included a Certificate of Need (CON) review and approval by the Green Mountain Care Board. He too set realistic expectations about how many tickets we’ll have at go live just like every other major EHR implementation around the country and thanked the interdisciplinary team involved.

Lori Boisjoli, UVMHN VP Application Portfolio, then framed the day for everyone. The morning would be focused on the UVMMC with revenue cycle and the full suite of specialty modules going live. The afternoon would be focused on the three affiliate sites where ambulatory clinical and revenue cycle are going live. She highlighted that GLRA is the time to raise any significant issues and risks so project leadership can capture them for follow-up. Continue reading →

M&A work is not just about technology

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Between the organizations I’ve served as CIO and the health systems I’m advising these days through StarBridge Advisors, I’ve seen plenty of M&A activity over the years. Mergers and affiliation agreements People putting the pieces together conceptcome in all sizes.

For a CIO there are the typical areas to look at for system consolidation and integration. But it’s not just about technology. You have to consider the people who are impacted.

I recently wrote an article for the CIO Techie Magazine Healthcare Technology Special Edition 2019 called “M&A activity continues – for IT leaders it’s not just about technology”. I advised on how best to retain talent while still ensuring the strategic goals of the organization and the drivers for the M&A activity are met. My advice:

  • Get to know your new partners and colleagues early
  • Remember that culture is key
  • Partner with HR early on
  • Communicate early and often
  • Think win-win not win-lose
  • Be kind and generous

Check out the full article here.

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It’s IT’s fault

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I was surprised to hear this from a front-line airline worker when I checked in at the gate. I probably shouldn’t have been surprised after all my years in IT. As I deplaned on the first leg of my flight, I realized canstockphoto7753679 (1) blameI didn’t have a mobile boarding pass for the second leg. I usually print my boarding passes – just seems easier to keep track of and quickly access than trying to find the specific email on my iPhone with the boarding pass link. But I had checked in for the flight from my hotel room late the previous night so opted for a mobile boarding pass.

The connection was going to be tight anyways. And then my first flight was 35 minutes late departing and I was sitting towards the back of the plane. I was connecting at O’Hare so I hustled from the H gates to the L gates fast as I could. When I got to the gate and said I didn’t have a boarding pass, the airline employee said, “it’s our IT department”. He told me how IT has some explanation about how the mobile boarding passes aren’t intended for connecting flights for security reasons. But I don’t recall any message during the online check-in saying I had to get my second boarding pass at the airport. Then he said it’s because they inherited the IT department from the other airline they had merged with.

As a healthcare customer, I’ve often heard registration clerks and other front-line workers blame “the system” for being slow or not working the way they’d expect it to. Another “it’s IT’s fault” explanation. But given I usually received my care at the provider organization where I was the CIO, what I heard was it’s my team’s fault.

After doing an IT review at a client where we talked with probably 60 leaders and staff, I saw how the “it’s IT’s fault” takes on many flavors. A sobering reminder of just how hard IT’s job really is, yet how much IT needs to listen to their customers and partner with them. Continue reading →

Outsourcing in health IT – is it time to reconsider?

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We probably all know at least one negative story on IT outsourcing in healthcare from years past. But the outsourcing pendulum is swinging back. As core IT services become more of a commodity and CIOs need canstockphoto20590634 outsourcingto focus on strategic initiatives, selective outsourcing is worth consideration.

The recent announcement that Trinity Health is outsourcing application management and rebadging approximately 450 staff is getting attention from other provider organizations. There are other examples – many in infrastructure.

More and more I hear from CIOs who are considering selective outsourcing for various reasons – reduce costs, modernize the infrastructure, provide scalability and flexibility as health systems grow, deal with recruiting and retention challenges, or focus on strategic initiatives instead of commodity services. Many CIOs are finding themselves part of overall cost reduction efforts at their health systems. While some CIOs start from a defensive posture and say they can’t possibly reduce costs any further, one of the most progressive IT leaders I know said she is looking at it as an opportunity to transform IT.

I was part of an organization wide cost reduction initiative when I served at Brigham and Women’s Hospital, Michigan Medicine and University Hospitals. As the CIO, I was asked to identify opportunities to reduce costs while other departments’ opportunities needed additional IT help to achieve their reductions. But saying no to cost reduction is usually not an option. CIOs must partner with their peers and engage their staff to identify opportunities. Continue reading →

IT matters – why I work in healthcare

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42,000 steps later and HIMSS19 is behind me. Heard insightful and moving speakers at the CHIME CIO Forum. Co-presented with Pam Arora on the relationship between IT and HTM. Sponsored the networking breakfast at the career fair. Facilitated a roundtable at the mentor meetup. Interviewed by Bill Russell for his This Week in Health IT podcast HIMSS series. Walked the exhibit hall. Had many great conversations with new and old colleagues. And promoted our new StarBridge Advisors service, C-change, receiving lot of positive feedback and enthusiasm.

Did I meet my HIMSS19 goals? Yes. Now it’s time for all the follow-up.

In the first two days I was reminded numerous times why I work in healthcare. The CIO Forum planning committee made some bold speaker decisions this year and I applaud them for it. The day included some very personal and touching stories. Continue reading →

#HIMSS19 – are you ready?

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If you work in health IT, you know that the annual HIMSS conference is the biggest annual industry event whether you are headed to Orlando in two weeks or not. The number of emails, blog posts, social media image001 (003) HIMSS19posts, and articles providing guidance and recommendations on HIMSS19 grows with each passing day. And to this year’s theme – yes, we are all champions transforming healthcare through technology!

With so much info out there and so many scheduling choices to make, here are a few more resources and recommendations that might help in your final preparation.

Whether you are attending in person or following the happenings from a distance, the Official HIMSS19 Hashtag Guide will help you focus in on your areas of interest. And of course, you’ll want to follow all the social media ambassadors.

Check out the StarBridge Advisors blog post from principal, David Muntz – “Prepare to visit HIMSS2019 – Health IT’s Magic Kingdom”. David gives his advice for optimal prep and shares our principals’ top picks for this year – mine are #WomenInHIT, #HITventure and #Engage4Health.

At the Career Development Seminar on February 11, David will be presenting “Opportunities in the Rapidly Changing HIT Environment” at Session #4 from 1:00PM-2:00PM and hosting a mentor roundtable on “Future of the Industry” at 3:15PM.

The career fair on Wednesday from 8:30AM-3:30PM is something to consider checking out if you are early in your HIT career, looking for a change, or just want to get some tips from the experts. There is no fee, but separate registration is required.

I’m looking forward to hearing the panel at the #WomeninHIT Meetup – Changing the Scales to #BalanceforBetter on February 12 from 3:00PM-3:45PM at the HIMSS Spot. StarBridge Advisors will be launching a new initiative focused on developing women leaders prior to HIMSS19 – more on this in an upcoming blog. Continue reading →

Just how dependent are we?

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You’ve probably been there. That feeling when you have to relinquish your smart phone for repair; you suddenly feel cut off from everyone and everything. You’re not on vacation, intentionally going off the grid. canstockphoto14698935 (1) smart phoneIt’s a work day. You need to stay connected. You have work to get done.

Tuesday was that day for me. The battery on my iPhone 6 Plus had been draining way too quickly. The battery setting said it needed service and I should bring it in. I made my appointment with the Genius Bar at the Apple Store about 15 minutes from my house. I blocked a two-hour window door to door. Seemed reasonable. I took some work with me to do while they were replacing the battery, but I didn’t think to bring my laptop.

I had a 12:30PM appointment. It was around 1:15 when they took the phone; they said it would be an hour before I would get it back. So much for my two-hour window. I headed to the food court for a quick lunch and did my other work – paper I’d brought with that I needed to review. I suddenly felt incredibly out of touch without my iPhone.

It took only about 15 minutes to review the papers with me. Now what? Well there was one purchase I needed so I headed to a store. I got back to the Apple Store at 2:15 and they weren’t done. The greeter told me it would be another 20 minutes. I thought of one other item I needed and headed to another nearby store.

I returned after 20 minutes. iPhone still not ready. I somewhat jokingly (though I was getting increasingly frustrated) told them this was costing me money since I hadn’t planned to shop that day. More importantly, I had a conference call at 3PM that I needed to do from home on my laptop. So much for thinking a two-hour window door-to-door was enough.

I got my iPhone back at 2:50PM. As it turns out, when they replaced the battery, the display wouldn’t work, and they couldn’t resolve it. So, I ended up with a brand-new iPhone 6 Plus for the price they were going to charge me for the battery. A good but unexpected ending in many respects.

As I ran out of time, they got me set up for phone and text. I quickly called one of the two people for the 3PM scheduled call and said I hadn’t been able to review the prep document that had been sent during this offline window and wouldn’t be able to do the call until 3:30PM.

I headed home with a phone with bare bones phone functionality. Not until I could take time later that day to do the iCloud restore would I be back to normal functioning. Continue reading →

Give the gift of girl power

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Every day is a good day to encourage reading and learning. And every day is a good day to buy books for kids. The holiday season is a time when many of us are looking for book recommendations for the young canstockphoto20702129 (1) girl power booksones in our lives.

With four grandkids and six grand nieces and nephews, I buy a lot of kid’s books. Of these ten young people, six are girls. When looking at books for the girls, I’m particularly interested in finding ones that will inspire them and teach them to be strong, smart girls who can be and do anything they aspire to. And, of course, I like to encourage an interest in STEM fields.

A few of the books I’m looking forward to buying for my granddaughters when they are a little older:

  • Women in Science: 50 Fearless Pioneers Who Changed the World, by Rachel Ignotofsky, highlights the contributions of women to science, technology, engineering, and math (STEM).
  • Herstory: 50 Women and Girls Who Shook Up the World, by Katherine Halligan, celebrates inspiring women who have changed the world.
  • Good Night Stories for Rebel Girls, by Francesca Cavallo, is a collection of bedtime stories of extraordinary women both past and present, each told as a fairy tale.
  • She Persisted and She Persisted Around the World, by Chelsea Clinton, describe the struggles of 26 remarkable, diverse and tenacious women.

There is a great series by Andrea Beaty that I’ve already introduced to my oldest granddaughter who just turned six. I gave her Rosie Revere, Engineer last Christmas. The other two books in the series are Ada Twist, Scientist and Iggy Peck, Architect.  Rosie, Ada, and Iggy are friends who pursue their passions with persistence while celebrating and learning from their failures.

If you have young girls to shop for this holiday season, I hope you will consider one of these books. And if you are looking for organizations to support as you consider your year-end charitable contributions, take a look at Girls Inc. With local organizations in cities across the country they inspire all girls to be strong, smart, and bold. Their message couldn’t be any clearer.

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Physician satisfaction with EHRs

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I am a huge fan of Dr. Atul Gawande. Who isn’t? He is a surgeon, an author and one of the most insightful and influential physicians of our time. His books are best sellers and his articles in The New Yorker canstockphoto3914104 (1) physician computermagazine are widely read. He was recently named as CEO of the non-profit-seeking health care venture formed by Amazon, Berkshire Hathaway, and JPMorgan Chase to deliver better outcomes, satisfaction, and cost efficiency in care. He will be the opening keynote speaker at HIMSS19 in Orlando this coming February.

His books include Better, Being Mortal: Medicine and What Matters in the End, Complications: A Surgeon’s Notes on an Imperfect Science, and The Checklist Manifesto. I gave one of his early books to all my IT leaders one holiday season. My tradition was to give them an insightful and inspiring book each year. Gawande’s books are clearly some of the best for health care leaders.

Gawande has been a staff writer for The New Yorker since 1998. His latest piece was titled “The Upgrade: Why Doctors Hate Their Computers”. It’s a long read but worth the time if you work in health IT and care about your physicians. Gawande describes the challenges of EHR’s from the front lines of medicine. He talks about the significant amount of time spent doing documentation after a patient visit and the loss of physician to patient connection with the computer competing for attention in the exam room.

In discussing physician burnout, he referenced Berkeley psychologist Christina Maslach’s work studying occupational burnout where she defined burnout as a combination of three distinct feelings – emotional exhaustion, depersonalization and a sense of personal ineffectiveness. He noted that in 2014, 54%% of physicians reported at least one of the three symptoms compared to 46% three years earlier. He shadowed a scribe and talked with surgeons and primary care physicians on the impact of the EHR on their work and their time. He learned from a patient who works as a construction supervisor that others are also challenged in their work to make the necessary human connections. Continue reading →